Is the medical community more conservative than most and why?

maninasia

Ok, I made a hash of the first attempt at this.

Let's stick to discussing conservatism in the medical profession. Does it attract people who are already conservative or do people become conservative overtime?

Is it because of the hierarchial nature of the medical system and fear of higher-ups and upsetting the applecart?

Is it because medicine is always 'safety first'? ( this opens up another debate, for instance a classic one I always think of is the use of slimming drugs, sure some slimming drugs have serious side effects, yet obesity and the diseases it brings with it seem to be worse than the side effects of the drugs, another one would be the reluctance to introduce modern diagnostic/scientific tests and trusting of old fashioned direct analysis and interpretation by Doctor more)

Is it because the education system selects for studious types first and foremost?
Do medical professionals like to think of themselves as openminded and liberal but they don't actually apply that in their workplace?
Or are people in medicine no more conservative than other areas?

Discuss.

ORLY?

What is your definition of conservative?

I'm afraid you're not going to be able to judge much of anything about a doctor's personality unless you know them outside of the job.

Do you have any friends that are doctor's, are they "conservative"?

maninasia

Right next, anyone with an opinion please?

ORLY?

I have plenty of opinions. It might actually help though if you were capable of articulating yourself a bit better. You do realise that "conservative" has a broad meaning. It might help if you explained what you mean, maybe gave example of how the medical community is conservative?

You've made some vague nonsensical remark about diet pills and talked about some so-called reluctance to bring in diagnostic tests. I don't know what you're tyring to say with the diet pills and I haven't picked up on any reluctance to bringing in new diagnostic procedures.

Frankly, I have no idea what you're tyring to say, nor do you, or if you do, you certainly don't know how to express yourself.

maninasia

You are typical of a person hedging their bets and redirecting the conversation. I have made myself perfectly clear thank you. You unfortunately follow the extremely defensive tone on this section of Boards.

As for diet pills, the point is that if you actually check the death rate from side effects of the pills you might note that it is lower than the death rate from diseases related to obesity. It may make more sense to put most fat people on slimming pills but we just don't see it because of the extreme conservatism and reluctance to change (this is related to FDA etc.).

In addition, it is well known and has been discussed on here previously that GPs do not use all the available diagnostic tests out there, in fact they use VERY few even though a diagnostic test gives an objective result rather than a subjective result. In the scientific and technological world subjective analysis is usually frowned upon. An analysis should be built up from reliable data, not from a whole heap of assumptions and best guesses. GPs have been very slow to incorporate diagnostic tests. Now that might be because there are solid reasons for this or that they are simply conservative and slow to change their ways.

ORLY?

maninasia wrote: »

You are typical of a person hedging their bets and redirecting the conversation. I have made myself perfectly clear thank you. You unfortunately follow the extremely defensive tone on this section of Boards.

As for diet pills, the point is that if you actually check the death rate from side effects of the pills you might note that it is lower than the death rate from diseases related to obesity. It may make more sense to put most fat people on slimming pills but we just don't see it because of the extreme conservatism and reluctance to change (this is related to FDA etc.).

In addition, it is well known and has been discussed on here previously that GPs do not use all the available diagnostic tests out there, in fact they use VERY few even though a diagnostic test gives an objective result rather than a subjective result. In the scientific and technological world subjective analysis is usually frowned upon. An analysis should be built up from reliable data, not from a whole heap of assumptions and best guesses. GPs have been very slow to incorporate diagnostic tests. Now that might be because there are solid reasons for this or that they are simply conservative and slow to change their ways.

I'm not being defensive, just trying to figure out what you're talking about. Now that you've put some substance behind some of your points I can have a go at addressing them.

Anti-obesity medication - I have often seen it prescribed quite a bit.

As for your point on GPs not using all available "diagnostic" tests, of course they don't. The lab would be clogged up, it would cost a fortune, because of the delays seriously ill people would not be diagnosed in time and then we'd be left with a whole load of healthy people with "abnormal" results that we didn't know what to do with.

If we just threw every available test at everyone, there wouldn't be a need for GPs and the general health of the nation would decrease and the budget deficit increase.

It's common sense, and best use of resources and minimising risk for patients and maximising the nation's health. It's nothing to do with "conservatism".

maninasia

What's your opinion on the anti-obesity pills?

As for diagnostic tests, I think common sense could be argued the other way, that a diagnostic test could give an accurate result (e.g. rapid test) that would save medical costs down the line and reduce need for human intervention (I am not the biggest fan of commonsense as it is too easy to skew to the 'current' way of doing things).

ORLY?

maninasia wrote: »

As for diagnostic tests, I think common sense could be argued the other way, that a diagnostic test could give an accurate result (e.g. rapid test) that would save medical costs down the line and reduce need for human intervention (I am not the biggest fan of commonsense as it is too easy to skew to the 'current' way of doing things).

I don't know enough about anti-obesity meds to talk about their benefits or disadvantages.

As for what you say above, who should get which tests and when?

maninasia

I'm sure there is a procedure that can be put in place. Somebody presents with a cough, runny nose etc. Hey I'm not a doctor but the diagnostic test should inform the final decision, working on a more scientific basis. It is incredible to me that a GP cannot accurately diagnose a flu or cold virus or even the strain of flu or cold (well they do but they don't use these tests regularly and they are not actually that expensive compared to prescription drugs some I'm wondering is it a resistance to technology or overconfidence in personal abilities or a cultural relic).

If one was a doctor it would make sense to look at 'if I prescribe anti-obesity drugs to most obese patients, even with side-effects, will they be better off in the main?'

I suspect many doctors are reluctant to do this due to training and also importanly liability i.e. the 1 in a 1000 that died from an anti-obesity drug side-effect caused heart attack would sue you but the 20 out of 100 that died from an obesity related heart attack won't sue you!

Dr Galen

why would a doctor need to diagnose the strain of cold or flu that someone is presenting with? In most cases the treatment would vary very little regardless of the strain. If you have a cold, you've got a cold, don't need bloods to be sent to decide on a treatment option tbh.

Regarding diet pills, well could you post some of the sources that you've read regarding death rates and how they compare to deaths from obesity related illnesses? Sounds interesting as a thought experiment if nothing else. Do you have any info on other side effects from said pills? Like other than death.

drkpower

I think you might have made a hash of your 2nd attempt also......;)

maninasia wrote: »

I'm sure there is a procedure that can be put in place. Somebody presents with a cough, runny nose etc. Hey I'm not a doctor but the diagnostic test should inform the final decision, working on a more scientific basis. It is incredible to me that a GP cannot accurately diagnose a flu or cold virus or even the strain of flu or cold !

As Dr G says, there is no point in doing a test if it does not change the management of the patient. It is a very sensible cornerstone of medicine. There are a thousand examples; this is one of them. Identifying the strain of a cold or flu virus is not going to make any difference. Nothing to do with conservatism........NEXT!

maninasia wrote: »

If one was a doctor it would make sense to look at 'if I prescribe anti-obesity drugs to most obese patients, even with side-effects, will they be better off in the main?' I suspect many doctors are reluctant to do this due to training and also importanly liability i.e. the 1 in a 1000 that died from an anti-obesity drug side-effect caused heart attack would sue you but the 20 out of 100 that died from an obesity related heart attack won't sue you!

Are doctors reluctant to prescribe authorised anti-obesity medications? Im not sure they are. But you might provide more info on this, coz noone seems to know where you are coming from.

The 2 examples you have given of the medical professions innate conservatism are not especially good. There are others, though. My number one example of conservatism is their reluctance to speak out on issues that affect their patients, to speak out against policy, or against their colleagues. Not sure 'conservatism' is the appropriate tag though; it is probably more self-interest.

0lddog

ORLY? wrote: »

If we just threw every available test at everyone, there wouldn't be a need for GPs and the general health of the nation would decrease and the budget deficit increase......

Is anyone suggesting that every available test should be thrown at everyone ?

Why would there be no need for GPs. ?

"The general health of the nation would decrease" - any proof ?

ORLY? wrote: »

As for your point on GPs not using all available "diagnostic" tests, of course they don't. The lab would be clogged up, it would cost a fortune, because of the delays seriously ill people would not be diagnosed in time and then we'd be left with a whole load of healthy people with "abnormal" results that we didn't know what to do with.

In fact the position is that seriously ill people are not being diagnosed in time due to GPs reluctance to use / ignorance of available tests.

For myself, I think that maninasia is being very polite in suggesting that the issue is one of "conservatism" in the medical profession.

Rodin

maninasia wrote: »

You are typical of a person hedging their bets and redirecting the conversation. I have made myself perfectly clear thank you. You unfortunately follow the extremely defensive tone on this section of Boards.

As for diet pills, the point is that if you actually check the death rate from side effects of the pills you might note that it is lower than the death rate from diseases related to obesity. It may make more sense to put most fat people on slimming pills but we just don't see it because of the extreme conservatism and reluctance to change (this is related to FDA etc.).

And fat people, renowned for their self control, will take these tablets religiously?

Rodin

maninasia wrote: »

I suspect many doctors are reluctant to do this due to training and also importanly liability i.e. the 1 in a 1000 that died from an anti-obesity drug side-effect caused heart attack would sue you but the 20 out of 100 that died from an obesity related heart attack won't sue you!

I'd imagine those 21 people wouldn't be in a fit state to sue anyone

SomeDose

maninasia wrote: »

If one was a doctor it would make sense to look at 'if I prescribe anti-obesity drugs to most obese patients, even with side-effects, will they be better off in the main?'

I suspect many doctors are reluctant to do this due to training and also importanly liability i.e. the 1 in a 1000 that died from an anti-obesity drug side-effect caused heart attack would sue you but the 20 out of 100 that died from an obesity related heart attack won't sue you!

First of all, the terms "diet pills" or "anti-obesity drugs" are essentially meaningless. That could mean anything from amphetamines to anti-diabetic medicines, so you need to specify exactly which class or individual drugs you're talking about.

Secondly, you've made a quantum leap of an assumption when you questioned why doctors don't prescribe them. You're assuming the "diet pills" actually work, and have a significant benefit on morbidity and mortality. Do they?

ORLY?

0lddog wrote: »

In fact the position is that seriously ill people are not being diagnosed in time due to GPs reluctance to use / ignorance of available tests.

Is that so? Thanks for clearing that up for us.

Dr Galen

maninasia wrote: »

I'm sure there is a procedure that can be put in place. Somebody presents with a cough, runny nose etc. Hey I'm not a doctor but the diagnostic test should inform the final decision, working on a more scientific basis. It is incredible to me that a GP cannot accurately diagnose a flu or cold virus or even the strain of flu or cold (well they do but they don't use these tests regularly and they are not actually that expensive compared to prescription drugs some I'm wondering is it a resistance to technology or overconfidence in personal abilities or a cultural relic).

If one was a doctor it would make sense to look at 'if I prescribe anti-obesity drugs to most obese patients, even with side-effects, will they be better off in the main?

I suspect many doctors are reluctant to do this due to training and also importanly liability i.e. the 1 in a 1000 that died from an anti-obesity drug side-effect caused heart attack would sue you but the 20 out of 100 that died
from an obesity related heart attack won't sue you!

Just a wordnto the wise OP. It's not generally considered good form to go bak to posts that you have previously written and people have subsequently responded to, and edit them. It tend to disrupt the flow of conversation and debate.

By all means clarify your points but this is usually done in a separate post not by editing a previous one, unless your dealing with special cases. Which we aren't

0lddog

ORLY? wrote: »

Is that so? Thanks for clearing that up for us.

You are both welcome

Please give my secretary two hundred Euros on your way out

ORLY?

drkpower wrote: »

My number one example of conservatism is their reluctance to speak out on issues that affect their patients, to speak out against policy, or against their colleagues. Not sure 'conservatism' is the appropriate tag though; it is probably more self-interest.

I'd have to agree with this. I'd call it being meek. There is a tendency to be extemely career conscious, leading to excess deference.

This might explain why so many consultants seem to be eh, somewhat eccentric, maybe it's the release of having to toe so many lines for so many years.

No offence to any consultants here.:)

Tree

Im going to step in from the diagnostics side, i've said this many times before. Not all testing is nessecary, it doesnt always provide additional information, it's a burden on the tax payer when it's done unnessecarilly, the new tests dont always ahve the same level of proven accuracy/sensitivity.

Most people are suffering from the majority of illnesses that do not benefit from more detailed testing than is done currently. Focus should instead be put on implementing prevention and screening programmes that we can genuinely provide accurate and valid results for in order to intervene early to ultimately save lives and cut costs.

Throwing diagnostics at a problem will rarely solve anything, a lot of the effort is on the side of the clinician and their experience in dealing with such cases in the past and from reading the literature.

tallaght01

Surely everyone can see that the OP is just looking for an argument? This is just a (very) thinly veiled attack.

Tree

tallaght01 wrote: »

Surely everyone can see that the OP is just looking for an argument? This is just a (very) thinly veiled attack.

But lookee the wickle troll, how could you not feed the poor thing, staring back up at us with its big doleful eyes

Prime Mover

Most professions that have a long history also have a degree of conservatism and tradition. Look at the legal profession. Speaking of which, Ireland being one of the most litigious countries in the world has a big affect on how doctors deal with patients.

With regard to those two strange examples:
- if you put patients straight on to drugs instead of attempting lifestyle modification there would be others on here posting that you were a tool of big pharma. Also, some of those drugs have a bad history
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm179871.htm

- you also seem to have no faith in clinical examination. Some signs can actually be quite specific. Also you avoid the VOMIT (victims of modern Imaging/investigation technology) scenarios.
http://www.bmj.com/content/326/7401/1273.1.extract

sam34

OK can we leave out the sniping and snide remarks please

maninasia

Again diagnostics are being written off far too quickly here. For instance, it is my impression (might be wrong again) that doctors can find it difficult to differentiate between a cold and flu. To my knowledge a flu is worse than a cold and should be treated more seriously. The strain of flu is also important, especially during pandemics. Then you've got bacterial infections that might be dangerous or confused with a flu/cold. So why not get science involved and more data to back up decisions making, diagnostic tests are relatively cheap, especially rapid tests. Why not take patients seriously when they say 'I want to know what disease I have', instead of sending them home and say you'll be fine in a few days.

I'm not totally talking out of my hat here as I am involved in life sciences.

There are people saying here that it is too costly, but I'm not sure I agree with this argument if you think it through. A GP is very costly to visit, a hospital stay is costly, prescribed drugs are extremely costly.

Then the obesity thing, you guys are the doctors not me. I am surprised you do not have any professional opinions on the matter. It is well known obesity is a leading cause of death, a drug that cuts fat peoples weight dramatically and long-term would obviously cut the fatality/serious illness rate dramatically, it should then depend on the relative serious of side-effects to make a decision. Where's the debate on this?

Rodin

A doctor that can't tell between a cold and a flu is not worth paying your money too.

And doing a PCR on a virus to see if it's adenovirus or Influenza. Ok, you know have the subtype. What are you going to do with this expensively obtained information? Back of the chart it goes.
Get real.

maninasia

You don't need to do PCR all the time, rapid tests can cover major flu subtypes, but if you look into PCR/NAT tests and technology are improving very rapidly. You may eat your own words in a few years.

Then you claim the tests are expensive, test for flutype A/B are less than a dollar (if centrally purchased). A has a high chance of being H1N1 virus. Don't belittle my concerns.

Seriously why the defensiveness, diagnostics is a tool to aid, not to be afraid of. Obviously the lack of concrete data is a major concern when doing a patient analysis. Look at how a modern car mechanic checks for faults. The cars are all wired up electronically now and the first thing they do is run a diagnosis program through a laptop, THEN they go ahead to do a manual inspection. Mechanics, some of the most traditional hands-on people, run with the technology and appreciate how it helps them make faster and better decisions.

Rodin

How much does this diagnostics testing cost? Hmm?

And a car is infinitely more simple than the complex human body.

Diagnostic tests are used by clinicians when they are financially prudent, and clinically justified to select treatment

And whats the actual turn around time for your influenza testing?
And I dont mean the time required for the test itself. I mean getting the sample to a lab, waiting in the queue behind the other samples, and then the report coming back. And you want everyone with the start of a sniffle to get this done?

maninasia

Rodin wrote: »

And fat people, renowned for their self control, will take these tablets religiously?

This is a very ignorant statement to make. Fat people, as you should know, are fat for many different reasons. There are plenty of slim people with no self control.

maninasia

Rodin wrote: »

How much does this diagnostics testing cost? Hmm?

And a car is infinitely more simple than the complex human body.

Diagnostic tests are used by clinicians when they are financially prudent, and clinically justified to select treatment

And whats the actual turn around time for your influenza testing?
And I dont mean the time required for the test itself. I mean getting the sample to a lab, waiting in the queue behind the other samples, and then the report coming back. And you want everyone with the start of a sniffle to get this done?

Seems you don't have a clue about rapid tests, results ready in 10 minutes.
http://www.craigmedical.com/Influenza.htm

Rodin

maninasia wrote: »

This is a very ignorant statement to make. Fat people, as you should know, are fat for many different reasons. There are plenty of slim people with no self control.

Fat people are fat for ONE reason only.
Their calorie intake exceeds their body's requirement.

Rodin

maninasia wrote: »

Seems you don't have a clue about rapid tests, results ready in 10 minutes.
http://www.craigmedical.com/Influenza.htm

How long is the current average GP consultation?

and your rapid testing influenza kit can not distinguish between two influenza subtypes and costs $1395 for 100 tests, which I work out at $13.95 a test just for the kit. I thought you said it was less than one dollar?

maninasia

Prime Mover wrote: »

Most professions that have a long history also have a degree of conservatism and tradition. Look at the legal profession. Speaking of which, Ireland being one of the most litigious countries in the world has a big affect on how doctors deal with patients.

With regard to those two strange examples:
- if you put patients straight on to drugs instead of attempting lifestyle modification there would be others on here posting that you were a tool of big pharma. Also, some of those drugs have a bad history
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm179871.htm

- you also seem to have no faith in clinical examination. Some signs can actually be quite specific. Also you avoid the VOMIT (victims of modern Imaging/investigation technology) scenarios.
http://www.bmj.com/content/326/7401/1273.1.extract

The point should be , ultimately, is what works and what doesn't. Obviously the current setup is not reducing obesity, it is becoming a worldwide epidemic with very serious health and economic consequences. Heading off obesity would drop rates of diabetes, heart disease and cancer dramatically!

maninasia

Rodin wrote: »

Fat people are fat for ONE reason only.
Their calorie intake exceeds their body's requirement.

This statement is not helpful, you should know many fat people don't feel satiety at a level that should fit their daily requirement. Many fat people's metabolism is slower. Some fat people are genetically programmed to be fat. Even viral infection is suspected to contribute to obesity as are changes in nutrition such as the switch from glucose to fructose in most processed foods.

If you check exercise rates of the last 30 years there has been no major change, therefore the finger points to an environmental effect as being major cause of increased obesity, not any major change in people's behaviour.

maninasia

Rodin wrote: »

How long is the current average GP consultation?

and your rapid testing influenza kit can not distinguish between two influenza subtypes and costs $1395 for 100 tests, which I work out at $13.95 a test just for the kit. I thought you said it was less than one dollar?

If centrally purchased should be a dollar or two. It's a simple test and manufactured in 100s of millions annually. How much does a GP visit cost these days, how about all the inappropriately prescribed drugs? You've been caught out on this one mate.

Rodin

maninasia wrote: »

This statement is not helpful, you should know many fat people don't feel satiety at a level that should fit their daily requirement. Many fat people's metabolism is slower. Some fat people are genetically programmed to be fat. Even viral infection is suspected to contribute to obesity as are changes in nutrition such as the switch from glucose to fructose in most processed foods.

If you check exercise rates of the last 30 years there has been no major change, therefore the finger points to an environmental effect as being major cause of increased obesity, not any major change in people's behaviour.

Don't feel satiety? Drink more water
Fat people's metabolism is slower? Then they need to eat less. Or exercise more.
Programmed to be fat? You dont get to 300lb, without going past 200lb. Use it as a warning.
No change in exercise rates in 30 years? What is your factual basis for this claim?
And as for the environmental effect for increased obesity, are you blaming the weather?

maninasia

I'm not here to give you an education, read the latest literature and books on the subject, of which there are many!

Rodin

maninasia wrote: »

If centrally purchased should be a dollar or two. It's a simple test and manufactured in 100s of millions annually. How much does a GP visit cost these days, how about all the inappropriately prescribed drugs? You've been caught out on this one mate.

Anyone who goes to a GP with a cold is a mug.

Your test does not in anyway change treatment. Nor does it identify any influenza virus as H1N1 which you were going on about earlier
It add little to 'any pains, chills, fevers, runny nose... sounds like flu'
And tell me, what is the sensitivity and specificity of these 'flu kits'?

Its 'results' are strongly positive, weakly positive, negative, invalid and no result. Quite what the difference between the latter two is I don't know.

Your craigmedical site also claims, and I quote 'Recently, antibiotic treatment of influenza has been developed. Drugs called neuraminidase inhibitors, as well as Amantadine and Rimantadine, are effective in decreasing symptoms if given within two days of the onset of symptoms. '

Can you spot the problem with that sentence?

Rodin

maninasia wrote: »

I'm not here to give you an education, read the latest literature and books on the subject, of which there are many!

I could tell that from your first post.
I think it is yourself that needs educated.

maninasia

Rodin wrote: »

Anyone who goes to a GP with a cold is a mug.

Your test does not in anyway change treatment. Nor does it identify any influenza virus as H1N1 which you were going on about earlier
It add little to 'any pains, chills, fevers, runny nose... sounds like flu'
And tell me, what is the sensitivity and specificity of these 'flu kits'?

Its 'results' are strongly positive, weakly positive, negative, invalid and no result. Quite what the difference between the latter two is I don't know.

Your craigmedical site also claims, and I quote 'Recently, antibiotic treatment of influenza has been developed. Drugs called neuraminidase inhibitors, as well as Amantadine and Rimantadine, are effective in decreasing symptoms if given within two days of the onset of symptoms. '

Can you spot the problem with that sentence?

I'm not interested in Craig Medical, it's a random website I chose, if you are a doctor you should know that the first step in diagnosing H1N1 is to use a Flu AB rapid test, if it comes back as A you can then decide to send patient for screening for H1N1. It's a good example of how rapid diagnostics help effective decision making. If H1N1 was to get to epidemic proportions in any country, the health and economic consequences would be enormous. I'm not interested in carrying on this conversation with you as I feel you have a closed and defensive approach plus an ignorant attitude to treatment of individuals.

drkpower

maninasia wrote: »

Again diagnostics are being written off far too quickly here. For instance, it is my impression (might be wrong again) that doctors can find it difficult to differentiate between a cold and flu. To my knowledge a flu is worse than a cold and should be treated more seriously.

Doctors can, in almost all cases, tell the difference between a cold and a flu; unfortunately, many, in an attempt to be seen to be treating a patient 'seriously', tell them they have a 'mild flu' rather than just being honest and saying you have a cold. NEXT!

maninasia wrote: »

There are people saying here that it is too costly

It is partly the cost, but it is more the lack of a real benefit. Identifying the strain of a virus is only going to help in the most unusual situations. So, produce a cost-benefit analysis or......NEXT!

maninasia wrote: »

Then the obesity thing, you guys are the doctors not me. I am surprised you do not have any professional opinions on the matter.

You are the OP. You havent framed your question properly. You havent given any evidence for the premise that underlies the issue (doctors arent prescribing anti-obesity pills' anti-obesity pills work....etc...)...NEXT!

The conservatism of doctors is actually an interesting topic. But your attempt to discuss it is....eh...laughable. NEXT!

Rodin

maninasia wrote: »

I'm not interested in Craig Medical, it's a random website I chose, if you are a doctor you should know that the first step in diagnosing H1N1 is to use a Flu AB rapid test, if it comes back as A you can then decide to send patient for screening for H1N1. It's a good example of how rapid diagnostics help effective decision making. If H1N1 was to get to epidemic proportions in any country, the health and economic consequences would be enormous. I'm not interested in carrying on this conversation with you as I feel you have a closed and defensive approach plus an ignorant attitude to treatment of individuals.

Then you need to choose your random websites more carefully.

''you should know that the first step in diagnosing H1N1 is to use a Flu AB rapid test, if it comes back as A you can then decide to send patient for screening for H1N1.''
''IMPORTANT NOTE: This test version tests for A and B Type Virus. It does not identify which virus type (A or is present.'''

Your kit can't do what you want it to do! Confirm or rule out subtype A!
And the company thinks antibiotics can be used for the flu!

Of course flu has great morbidity, and of course obesity also has too. But your ideas of how to overcome them are very very poor and clearly ill thought out.

maninasia

Identifying conclusively if it is a cold/flu will help. Identifying if it is a certain flu type will definitely help (as I have clearly shown). Finding other methods to treat obesity will help. I don't need to frame the whole subject for you as I feel you are the professionals but I will put an example up now.

http://en.wikipedia.org/wiki/Anti-obesity_medication

Side effects
Some anti-obesity drugs have severe or life-threatening side effects, fen-phen being a famous example. These side effects are often associated with their mechanism of action. In general, stimulants carry a risk of high blood pressure, faster heart rate, palpitations, closed-angle glaucoma, drug addiction, restlessness, agitation, and insomnia.
Another drug, orlistat, blocks absorption of dietary fats, and as a result may cause oily spotting bowel movements (steatorrhea), oily stools, stomach pain, and flatulence. A similar medication, designed for patients with Type 2 diabetes, is Acarbose which partially blocks absorption of carbohydrates in the small intestine, and produces similar side effects including stomach pain, and flatulence.


Fen-phen obviously scared off a lot of companies and doctors from this area due to liability concerns-
http://en.wikipedia.org/wiki/Fen-phen

New drugs in development
http://biopharmconsortium.com/blog/2010/09/23/preregistration-antiobesity-drugs-two-down-one-to-go/


I guess the problem comes down to the extremely high safety criteria set my the FDA and other national drug administration bodies, combined with the liability risk.

maninasia

Rodin wrote: »

Then you need to choose your random websites more carefully.

''you should know that the first step in diagnosing H1N1 is to use a Flu AB rapid test, if it comes back as A you can then decide to send patient for screening for H1N1.''
''IMPORTANT NOTE: This test version tests for A and B Type Virus. It does not identify which virus type (A or is present.'''

Your kit can't do what you want it to do! Confirm or rule out subtype A!
And the company thinks antibiotics can be used for the flu!

Of course flu has great morbidity, and of course obesity also has too. But your ideas of how to overcome them are very very poor and clearly ill thought out.

I told you I DONT CARE ABOUT CRAIG MEDICAL. Stop trying to find microscopic holes in my argument. My argument still stands, in blue here. ''you should know that the first step in diagnosing H1N1 is to use a Flu AB rapid test, if it comes back as A you can then decide to send patient for screening for H1N1' . I know this as it is the standard procedure in the country I reside in, aswell as in Japan and many other countries.

You say my ideas are 'poorly thought out'. Pray tell me what the last 3 decades have acheived in the treatment of obesity? If NASA was to keep using the same shuttle to send people to the moon and it kept failing for 30 years they would change their shuttle after 5-10 years. So the lack of progress, in fact the worsening of the epidemic, points to fundamental problems in the treatment and understanding of this disease.

The other part I find conservative about doctors, and Drkpower alluded to, is their unwillingness to really share information. The patient is also a customer, whether you like it or not, patients are not kids. If somebody asks a basic question as to what they have they should be given the CORRECT information. If they want a test to confirm why not give them the test? Sometimes I think it is a little bit of a power struggle, with the doctor unwilling to cede power to the patient in some regards.

Rodin

maninasia wrote: »

I told you I DONT CARE ABOUT CRAIG MEDICAL. Stop trying to find microscopic holes in my argument. My argument still stands, in blue here. ''you should know that the first step in diagnosing H1N1 is to use a Flu AB rapid test, if it comes back as A you can then decide to send patient for screening for H1N1' . I know this as it is the standard procedure in the country I reside in, aswell as in Japan and many other countries.

And I asked you, how long the turnaround time was for such a test to identify subtype!! It was you that volunteered Craig Medical as a quick test. But this quick test DOES NOT identify individual specific strains of flu! Which it seems you are so desperate to identify.

So I shall ask again, how long does it take to identify a specific strain of flu? From swab to result? Including sample transport time. And is it, in the context of a public health system, economically prudent?

And as for Orlistat, how much weight can a patient lose while using it? Is it effective?

maninasia

http://www.medcompare.com/spotlight.asp?spotlightid=86

10 minutes..I told you already. It identifies A or B which is a criticial step in the assesment of whether the patient could have the virulent H1N1 subtype of not. If the H1N1 is deemed prevalent in the country the health authorities will order the doctor to send a sample of every patient tested to a clinical laboratory for H1N1 testing. The doctor may also choose to send a sample on his own volition, simply to screen out and to reassure the patient.
They are useful as a first screening aid.

In the near future POC testing using PCR/NAT technology will arrive and it will be used as standard, I believe because patients will start to demand it, not because doctors will be proactive to introduce it.

Rodin

maninasia wrote: »

http://www.medcompare.com/spotlight.asp?spotlightid=86

10 minutes..I told you already. It identifies A or B which is a criticial step in the assesment of whether the patient could have the virulent H1N1 subtype of not. If the H1N1 is deemed prevalent in the country the health authorities will order the doctor to send a sample of every patient tested to a clinical laboratory for H1N1 testing. The doctor may also choose to send a sample on his own volition, simply to screen out and to reassure the patient.
They are useful as a first screening aid.

In the near future POC testing using PCR/NAT technology will arrive and it will be used as standard, I believe because patients will start to demand it, not because doctors will be proactive to introduce it.

Not one of those kits on that page can specifically identify Influenza A in ten minutes

And a quick clinical history will tell you all you need to know about whether a patient is worryingly unwell, or will be ok once the virus has run its course.

maninasia

SomeDose wrote: »

First of all, the terms "diet pills" or "anti-obesity drugs" are essentially meaningless. That could mean anything from amphetamines to anti-diabetic medicines, so you need to specify exactly which class or individual drugs you're talking about.

Secondly, you've made a quantum leap of an assumption when you questioned why doctors don't prescribe them. You're assuming the "diet pills" actually work, and have a significant benefit on morbidity and mortality. Do they?

It's known they can take a significant amount of weight off. It's not very well known how long the weight stays off or how long to continue taking the pills, but that's because of the liability and extreme safety rules applied by the FDA.
I have seen many people use them in Asia and don't see people dropping like flies from them (although it is risky of course).

Referencing the one mentioned earlier, Orlistat
http://en.wikipedia.org/wiki/Orlistat

It seems that it only takes 2-3 kg off of bodyweight but has reduced diabetic incidence in obese people by 40%! I think the FDA is too conservative in not allowing obese people make their own choices on the matter in the use of more effective but risky anti-obesity medicine, whether that includes Doctors conservatism I am not sure. I am pretty sure that if people were allowed to make their own choices the overall incidence of disease would makeup for the more rarely reported adverse side effects. Obesity-related diseases are some of the most common causes of death before the age of 75, they include

• high blood pressure
• high cholesterol
• diseases related to hardening of the arteries such as heart attack and stroke (cardiovascular disease).
• type 2 diabetes
• some types of cancer.

maninasia

Rodin wrote: »

Not one of those kits on that page can specifically identify Influenza A in ten minutes

And a quick clinical history will tell you all you need to know about whether a patient is worryingly unwell, or will be ok once the virus has run its course.

A doctor can NEVER tell you if it is A or B type....but this test can tell you

Sensitivity A-94%, B 74% - Nasal Swab
A-83%, B 67% - Nasopharyngeal swab
A-77%, B 82% - Nasal aspirate/nasal wash
Instrumentation Needed No
Cutoff Inquire
Specificity A-90%, B 97% - Nasal Swab
A-89%, B 98% - Nasopharyngeal swab
A-99%, B 99% - Nasal aspirate/nasal wash

It is not entirely dependent on the doctors experience or skills or attention, which is good enough for the WHO and Japan CDC and numerous health organisations around the world!

You are wrong about H1N1, the serious symptoms can occur after the patient has returned home, they can also transmit to countless other individuals, I hope you can learn more about this subject. I hope you are not a practising doctor with your attitude to patients and your insistence on twisting the facts.

Rodin

maninasia wrote: »

It's known they can take a significant amount of weight off. It's not very well known how long the weight stays off or how long to continue taking the pills, but that's because of the liability and extreme safety rules applied by the FDA.
I have seen many people use them in Asia and don't see people dropping like flies from them (although it is risky of course).

It seems that it only takes 2-3 kg off of bodyweight but has reduced diabetic incidence in obese people by 40%! I think the FDA is too conservative in not allowing obese people make their own choices on the matter in the use of more effective but risky anti-obesity medicine, whether that includes Doctors conservatism I am not sure. I am pretty sure that if people were allowed to make their own choices the overall incidence of disease would makeup for the more rarely reported adverse side effects. Obesity-related diseases are some of the most common causes of death before the age of 75, they include
]

No-one is saying obesity isn't a problem!! Dear god. are you for real?
And I am WELL aware of the associated problems!
2-3 kg? Thats it? And if you delve further, that is while on a low-fat diet!
And please show me where I can read further about Orlistat ALONE reducing the incidence of diabetes in the obese by 40%. I look forward to reading that.

maninasia

I'm not a supporter of Orlistat, I want to see YOUR views on whether if anti-obesity drugs were introduced they would be more beneficial overall even with the odd serious side-effect/fatality?